PSY240 2. Assessment Flashcards

Question 1

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Purpose of Assessment

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used to diagnose
establish a baseline
understand nature of problems

Question 2

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Purpose of Assessment

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=identify strengths (things to draw on)
e.g. good verbal communication - psychodynamic therapy
weaknesses
aid in treatment planning - apply treatment effectively with proper diagnoses

Question 3

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Gathering Information: Symptoms and History

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• Current symptoms
how much they interfere with functioning
how do they cope?
how much distress?

Question 4

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Gathering Information: Symptoms and History

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• Recent events
negative events recently
are these events tied to the symptoms somehow
e.g. PTSD
Gives insight to level of functioning

Question 5

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Gathering Information: Symptoms and History

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-e.g. adjustment disorder
impairment due to recent event
avoiding overpathologizing normal events
• History of psychological disorders
have they experienced similar symptoms in the past?
need to see symptoms over course of life

Question 6

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Gathering Information: Symptoms and History

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-e.g. psychotic disorders
schizo gets diagnosed if 6 months or later
bipolar disorders - hypomanic or depressive episodes then they can’t get diagnosed with a unipolar disorder such as depressive disorders

Question 7

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Gathering Information: Symptoms and History

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-• Family history of psychological disorders
insight on childhood, genetic vulnerabilities
e.g. perceptual abnormalities with family history of schizo - categorize them as high risk

Question 8

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Physiological and Neurophysiological Factors

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• Physical Condition
do they have medical disorders?
e.g. underactive thyroid - similar symptoms as depressive
if they can be treated with medication, then it’s not MDD
• Drug and Alcohol Use
might cause or exacerbate symptoms
e.g. substance induced depressive disorder
might be on medication that is not to be mixed with what they’re going to be prescribed

are there cognitive deficits that might cause symptoms
e.g. youth - anxiety of school: may be better treated with learning disability

when considering 2/+ disorders
try to tease out potential symptoms and more specific symptom presentation

Question 9

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Physiological and Neurophysiological Factors

Question 10

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Physiological and Neurophysiological Factors

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• Intellectual and Cognitive Functioning • Important for differential diagnosis

Question 11

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Gathering Information: Sociocultural Factors

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• Social Resources

Question 12

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Gathering Information: Sociocultural Factors

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-• Sociocultural Background

• Acculturation

Question 13

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Gathering Information: Sociocultural Factors

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do they have friends and family? how much contact? what’s the relationship like?
social support can be a protective factor and buffer to alleviate stress

practice multicultural competence
don’t diagnose as abnormal if normal in cultural background

to what extent do they identify with heritage or host culture?
e.g. ambivalence over conflict with traditional parent and culture of peers-

Question 14

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Gathering Information: Sociocultural Factors

Question 15

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Gathering Information: Sociocultural Factors

Question 16

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Approaches to Classification

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Categorical Approach

– ALL criteria must be met; Assumes unique etiology

Question 17

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Approaches to Classification

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Prototypical approach

– MOST criteria must be met (DSM) Dimensional approach

Question 18

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Approaches to Classification

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-– Characteristics of disorders can vary in severity

– Psychopathology represents extremes on a continuum

Question 19

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Approaches to Classification

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have to have 5 symptoms present
e. g. downsyndrome: trisomy 21

not assume that all are met
e.g. MDD: 5/9 symptoms
are you depressed?

most natural characteristics distributed among pop as normal curve
categorical understands it at the extremes - statistically unlikely
e.g. how depressed are you?

Question 20

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Approaches to Classification

Question 21

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What Best Describes Patients?

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-are they better described on a continuum or as categories?

Question 22

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What Best Describes Patients?

Question 23

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What Best Describes Patients?

Question 24

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Categories vs. Dimensions

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Dimensions show superior psychometric properties – 15% increase in reliability
– 37% increase in validity

Question 25

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Categories vs. Dimensions

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based on analytic studies

why doesn’t DSM use it?-

Question 26

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Categories vs. Dimensions

Question 27

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Scale Construction

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Articulate construct and content.

Choose response format. Assemble initial item pool.

Question 28

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Scale Construction

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Collect data

Examine psychometric properties and quality

Question 29

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Scale Construction

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Final scale

Question 30

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Scale Construction

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-be specific: definitions may be different

is it gonna be yes/no or a rating scale from 1-5
generating potential questions

if it doesn’t work out then go back to step 1
once satisfactory we use final scale in research

Question 31

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Scale Construction

Question 32

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Important Assessment Characteristics: Validity and Reliability

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-reliable, but not valid - same results, but not measuring the construct
reliable and valid
unreliable and hence not valid

Question 33

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Important Assessment Characteristics: Validity and Reliability

Question 34

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Important Assessment Characteristics: Validity

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Type l Description

Face l Test measures what it is supposed to measure

Question 35

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Important Assessment Characteristics: Validity

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Construct l Test measures what it is supposed to measure and not something else
Content l Test assesses all important aspects of phenomenon

Question 36

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Important Assessment Characteristics: Validity

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Concurrent l Test yields the same results as similar measures
Predictive l Test predicts what it is supposed to measure

Question 37

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Important Assessment Characteristics: Validity

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=meaningfulness and usefulness of the scale

construct: e.g. highly correlated with depression, not somatic complaints
GRE: expected to be correlated with IQ, not with gender

e.g. physical symptoms and distress levels

both criterion
external measure we’re comparing it to
take existing valid test and testing correlation

comparing with something that’s in the future
e.g. comparing IQ with GRE in the future

Question 38

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Important Assessment Characteristics: Validity

Question 39

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Important Assessment Characteristics: Reliability

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Type l Description

Test-Retest l Test produces similar results when given at two points in time

Question 40

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Important Assessment Characteristics: Reliability

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Alternate Form l Two versions of the same test produce similar results
Internal l Different parts of the same test produce similar results

Question 41

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Important Assessment Characteristics: Reliability

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consistency and repeatability

temporal stability
e.g. IQ - beginning and end of class, thought to be stable

diff versions should achieve same results

components of same test: e.g. first half same results as second half

diff interviewers - do they have same diagnostic conclusion?
critical consensus to get most helpful treatment

reliability is necessary, but not sufficient for validity-

Question 42

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Important Assessment Characteristics: Reliability

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Interrater or Interjudge l Two or more raters or judges who administer a test to an individual and score it come to similar conclusions.

Question 43

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Important Assessment Characteristics: Reliability

Question 44

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Inter-rater Reliability

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Subject Rater Outcome

Client => Dr. X =>

Question 45

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Inter-rater Reliability

Answer

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-Bipolar
Disorder
Bipolar
Disorder/Schizo
good internal reliability

not reliable assuming similar skills and training

Question 46

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Inter-rater Reliability

Question 47

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Inter-rater Reliability

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Client => Dr. Y

Question 48

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Inter-rater Reliability

Question 49

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Assessment Tools: Clinician-Rated Tools

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The Clinical Interview
• Intake interview: gather info on person’s life
– Usually focuses on presenting problem

Question 50

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Assessment Tools: Clinician-Rated Tools

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– Structured, semi-structured, or unstructured

Question 51

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Assessment Tools: Clinician-Rated Tools

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• Limitations of Interviews

– Resistance from the client

Question 52

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Assessment Tools: Clinician-Rated Tools

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– Selective information provided by the client

Question 53

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Assessment Tools: Clinician-Rated Tools

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-what symptoms brought you here?
structured: specific questions - pulled for responses that are more concrete
e.g. have you been feeling down
unstructured: open ended
e.g. how are you feeling
semi-structured: in between

interviews tough especially first time
e.g. looking to obtain services from insurance
embellish symptoms
e.g. present selves in best possible light
parents for custody

Question 54

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Mental Status Exam

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Components

Appearance and behavior
Thought Processes

Question 55

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Mental Status Exam

Answer

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Mood and affect

Question 56

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Mental Status Exam

Answer

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Intellectual functioning

Question 57

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Mental Status Exam

Answer

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Sensorium

Question 58

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Mental Status Exam

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-1. e.g. groomed
overt, observable behaviour
what they’re wearing, posture, behaviour
2. rate, continuity, content of speech
does it make sense? is it cohesive?
3. predominant feeling state
4. extent of vocabulary
metaphor and abstract ability
5. awareness of surroundings
aware of person, place or time

Question 59

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Assessment Tools: Behavioural Observations and Self-Monitoring

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• Behavioural Observation
– Problems with inter-rater reliability
e.g. how they behave in class, interact with peers and teacher
operationalize construct - clear definition of what we’re looking for
improve inter-rater reliability

e.g. track how many cigarettes they’re smoking
prone to self-report biases

Question 60

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Assessment Tools: Behavioural Observations and Self-Monitoring

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– Must “operationalize” the behaviour

Question 61

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Assessment Tools: Behavioural Observations and Self-Monitoring

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• Self-Monitoring

– Open to self-report bias

Question 62

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Assessment Tools: Behavioural Observations and Self-Monitoring

Question 63

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Assessment Tools: Behavioural Observations and Self-Monitoring

Question 64

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Projective Tests

Answer

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• Rorschach Inkblot Test

Answer 50

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• Thematic Apperception Test (TAT)

Answer 51

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• The Sentence Completion Test

Answer 52

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• Draw-A-Person Test

Answer 53

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-Rorschach Inkblot: what they see
detailed scoring method based on human movement, use of colour, location
Thematic Apperception Test: what is happening in this picture
tell dramatic stories
Sentence Completion: e.g. my mom is ____
Draw-a-person

ambiguous and open ended
Freudian: tap into unconscious
draw inferences from themes
concerns with reliability and validity - open to human interpretation error

Answer 54

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• What makes them objective?

– Results are independent of evaluator bias

Answer 55

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– Standardization
• Examples
– Intelligence tests (WAIS-III, WISC-III)

Answer 56

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– Achievement tests (WIAT-III; WRAT-4)
– Neuropsychological tests (D-KEFS; NEPSY)
– Questionnaires (MMPI-II, PAI; BDI-II; CBCL)

Answer 57

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-IQ

school

memory, processing skills, inhibition

Personality and symptoms

Answer 58

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Used to determine strengths and weaknesses

* Help place and determine resources for children

Answer 59

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-• Results

– Test-by-test (e.g., e.g., Vocabulary, Digit Span)

Answer 60

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-– Composite Scores (e.g., Verbal Comprehension, Working
Memory, Processing Speed, Perceptual Reasoning)
– Full Scale IQ (overall intellectual functioning)

Answer 61

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-gifted vs. learning disability
placement

8-12 tests - tap into different abilities
e.g. blocks, identify images

Answer 62

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Criticisms

• Little agreement on definition of intelligence

Answer 63

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-• Most tests only assess verbal and analytical abilities
• Biased toward middle and upper-class educated

Answer 64

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-don’t test emotional skills

standardization based on well-to-do pops

Answer 65

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• Learned skills and knowledge
• Assesses
– Strengths

Answer 66

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– Weaknesses

– Progress

Answer 67

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-measure learner progress
guides teachers for what is helpful when showing difficulties
e.g. WIAT or RAT
need to say standardized achievement test necessary to assess strengths, not specifically

Answer 68

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• Used when neurological dysfunction is suspected

Answer 69

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• Allow inferences about brain-behaviour relationships
• May also be used with normally functioning brains
car crash or alzheimers
not observable damages in head
get at functioning without brain-imaging
full range of neuro-psychological functioning

Answer 70

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-ask them to recreate image
indicate visual-motor maturity
showing 9 figures on 3x5 card
Tower task: how quickly, point out mistakes, do they plan out actions?
make pegs on board look like image with rules

Answer 71

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• Symptom Checklists
– May cover a wide variety of symptoms
– e.g., Revised Beck Depression Inventory (BDI-II)

Answer 72

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-• Personality Inventories
– Assess people’s typical ways of thinking, feeling, and acting
– e.g., Minnesota Multiphasic Personality Inventory (MMPI-2)

Answer 73

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how severe symptom is?
e.g. are you tired sometimes? all the time?

widely used in clinical practice
how they usually think, feel and act
personality style and symptoms

Answer 74

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• 338 True/False Statements
can get computer printouts using standardized scores
indicates range warranting clinical attention

Answer 75

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Mean = Average
• Standard Deviation (SD) = variability from the mean
– Used to calculate standardized scores

Answer 76

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• Types of Standardized Scores:
– Z-score: SD units
– T-score: M = 50, SD = 10

Answer 77

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Steps to standardization
1. Collect data from large representative sample
• AKA “standardization sample”

Answer 78

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-2. Standardize standardization sample scores
• Raw score mean ÆT-score mean = 50
• Raw score SD ÆT-score SD = 10

Answer 79

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• Standardization mean: μ = 3.25
• Standardization SD: SD = .90
Compute your z-score (e.g., raw score = 2.50)
Z = X – μ / SD
Z = (X – 3.25) / .90
Z = (\_\_\_\_ – 3.25) / .90
Z = \_\_\_\_\_ / .90
Z =

Answer 80

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IQ:
Mean = 100
SD = 15

Answer 81

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• Images of brain structure
– CT (or CAT) scan
– MRI

Answer 82

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-• Images of brain functioning
– PET scan
– SPECT
– fMRI

Answer 83

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cite and extent of brain damage
identify specific deficits and abnormalities

X-Ray beams passed through brain - just an image
magnets to generate 3D image

activation patterns
inject radioactive isotope and measure movements of photons in brain
gamma rays to generate 3D image
brain activity by looking at changes in blood flow
regions of brain in ppl with + without depression

Answer 84

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Limitations
absent of human interpretation
norms unavailable - can’t standardize
expensive
patients exposed to radioactivity
localizations of brain functions not fully known

Answer 85

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• Electroencephalogram (EEG)

– Event-related potential (ERP)

Answer 86

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• Electrodermal response
peripheral measures of electrical activity
sensory or cognitive, motor event - brain activity following provocation
neurons communicating chemically and electrically

galvanic skin response
sweat in response to stimulants

Answer 87

A

rely on various assessments because no one test is perfect
• Cultural Bias
– Language barriers
– Different cultures may experience disorders differently

Answer 88

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• Evaluating Children
– Difficulties in communication and reporting
– Parent-child discrepancies are common

Answer 89

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parents don’t have good insight on what adolescents experience on a day to day basis
standardized measures for parents and youth
no perfect overlap in responses

Answer 90

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It is difficult to convince people to participate
Abnormality is difficult to measure
Most forms of abnormality have multiple causes

Answer 91

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-2. we need a good concept to define abnormality
biases - e.g. overendorsing symptoms
3. we have to do a lot of research to find all causes

Answer 92

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Defining a problem

2. Specifying a testable hypothesis (educated guess)

Answer 93

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-3. Choosing and implementing a research method
4. Analyzing data, drawing appropriate conclusions, and
communicating the findings

Answer 94

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1. justify research
  1. needs to be amenable to research
  2. insight on research design we want to use
  3. basing conclusions on data + communicate it to other researchers

Answer 95

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Tested in two ways:

1. As predicted (as in, there is a relationship or effect)

Answer 96

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-2. As if your prediction is incorrect (no relationship)
• null hypothesis
are there significant correlations?
comparing to null hypothesis - wanna disprove this

Answer 97

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• Dependent Variable (DV):
– variable being predicted/measured (outcome)
• Independent Variable (IV):
– variable being manipulated (predictor)

Answer 98

A

-e.g. DV: Depression Scores

IV: depression status

Answer 99

A

Internal: Is the IV really causing the DV?

2. External: Do study results relate to real world?

Answer 100

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-how confident we are that it is not due to confounds
random assignment

generalizability of results
how can they be generalized for the real world
don’t get randomly assigned in real world

Answer 101

A

• Case studies
• Self-report data
• Observational approaches
study design may depend on who is providing info

having trained judges observe kids

Answer 102

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-more detail when focusing on 1 person

helps set stage for more empirically valid research

Answer 103

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Advantages

Provide rich and unique detail
May be only way to study rare problems
Good for generating ideas and hypotheses

Answer 104

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-more detail when focusing on 1 person

helps set stage for more empirically valid research

Answer 105

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Disadvantages

Low generalizability
Biased / lack objectivity
Hard to replicate

Answer 106

A

maybe the person is an anomaly, can’t assume they hold for diverse pops
requiring 1 person to interpret results

Answer 107

A

• Correlation: strength of association between two variables

• Correlation coefficient (r):
– Statistic reflecting strength of association
– Ranges from +1.00 (positive) to -1.00 (negative)

Answer 108

A

-positive - same direction

negative - opposite/inverted directions

Answer 109

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-• Statistical significance:
– Conventional threshold
– Results cannot be attributed to chance (p

Answer 110

A

-no discernable pattern

Answer 111

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-positive correlation

Answer 112

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• Cross-sectional: measurement at one time point

– Cohort effects

Answer 113

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• Longitudinal: measure same group over time
– Permits conclusions about change/development
– Expensive (time and labour)
– Research standards change over time
– Attrition

Answer 114

A

-prone to cohort effects
e.g. born after 9/11 may be affected
may be different than someone born in 80s

can’t be confident in causation
more confident in longitudinal
because of sequencing you might get causation
are we still measuring same thing if standards change

Answer 115

A

• Advantage: reflect real world problems
– Results can be generalized to real life
– Depends on representativeness of sample
• Disadvantages: cause vs. consequence challenge
– Third variable problem
– Importance of timing and measurement

Answer 116

A

depends on sample - larger, more generalizable

needs to measure consistently same things
take extra statistical precautions so that IV is causing DV
maybe there’s another variable that’s causing a spurious relationships
relationships dependent on when and how we’re measuring things
e.g. we have to measure stress before depression because depressed ppl create stress

Answer 117

A

• Estimate distribution of diseases in a given population
– Prevalence rates: cases of a disorder at any one time
– Incidence rates: new cases during a specific time period
– Risk factors
• Same limitations as correlational studies

Answer 118

A

-large representative samples
can run tests to check correlation within assessments
e.g. income and depression

Answer 119

A

-treatment studies

confident in causation

Answer 120

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• Involve:
– Control and manipulation of independent variable (IV)
– An experimental group or condition
– A control group or condition

• Allows for making cause and effect statements

Answer 121

A

Advantages
• More control
• Random assignment
• Control groups

Answer 122

A

confident in internal validity

ethical: offering treatment to some and not others

Answer 123

A

Disadvantages
• May not generalize
• Ethical limitations

Answer 124

A

• Effectiveness Studies: Treatment as usual

– Maximize external validity

Answer 125

A

• Efficacy Studies: Controlled experimental research
– e.g., randomized controlled trial (RCT)
– Maximizes internal validity

Answer 126

A

-confident that there is similar effects in real world patients

tradeoff between internal and external validity

Answer 127

A

Advantages • Help those in distress

Answer 128

A

-Disadvantages
• What causes improvement?
• Issues with control groups &amp;
randomization
• Must balance patients’ needs
with standardization
• Generalizability is unclear

Answer 129

A

maybe can’t afford psychotherapy - not covered by OHIP

reliant on strict inclusion and exclusion criteria

Answer 130

A

• Animal studies:
– When ethical concerns preclude use of humans subjects
• Single case designs:
– e.g., ABAB or reversal design
– The participant acts as his or her own control

Answer 131

A

Twin Studies
• Dizygotic twins (DZ): 50%
• Monozygotic twins (MZ): 100% -

Answer 132

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Adoption Studies:
• Look at rates of disorders in adopted probands
• Sensitive at identifying environmental effects

Answer 133

A

• Genome Wide Association Studies
– Examine many common genetic variants
– Is any variant is associated with a specific trait?

• Candidate Genes Research Studies
– Is a marker overrepresented among those with a disorder?
– Problems: $$$; multigenic nature of most traits

Answer 134

A

• Epigenetics: Environmental impact on gene function

• Hormones influence gene expression
– Pubertal hormones

• Psychosocial factors influence biology
– Stress and social interactions Æ hormones

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PSY240 2. Assessment Flashcards

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